- Hypomagnesium caused by alcoholism.
- Ingestion of phosphates.
- Inadequate intake of dietary calcium and/or Vitamin D.
Patients who experience hypocalcemia may have the following symptoms:- Depression.
- Memory loss.
- Confusion.
- Hallucinations.
- Numbness and tingling in the face, around the mouth, and in the hands
and feet. - Muscle spasms in the face, around the mouth, and in the hands and feet.
- Hyperreflexia.
- Ventricular tachycardia.
Patients with hypocalcemia can be treated as follows:- Calcium preparations can be given PO in tablet, capsule, or powder form
or IV. If given IV, then mix with 5% dextrose in water. Do not mix with a
saline solution because sodium encourages the loss of calcium. - Administer parenteral calcium. Caution: tissue infiltration leads to necrosis
and sloughing. Calcium increases the action of digoxin and can result in
cardiac arrest. Don’t add calcium to bicarbonate or phosphorus because
precipitates form. - Administer the following medication intravenously if ordered:
° Calcium chloride IV 10 mL
° Calcium gluceptate 5 mL
° Calcium gluconate 10 mL - Administer the following medication PO if ordered:
° Calcium carbonate (Os-cal, Tums, Caltrate, Megacal) 650–1500 mg tablets
° Calcium gluconate (Kalcinate) 500–1000 mg tablets
° Calcium lactate 325–650 mg tablets
° Calcium citrate 950 mg tablet - Take safety precautions because the patient is at risk for tetany and seizures.
- Tell the patient to refrain from alcohol and caffeine because they inhibit
calcium absorption. - Increase dietary calcium to 1500 mg/day by eating green leafy vegetables
and fresh oysters and milk products.
CHAPTER 10 Fluid and Electrolyte Therapy^175